A MINISTRY of Health audit of accounts for the financial year ended December 31, 2020 has revealed that the University Teaching Hospital has been using 25 faulty ventilators which were supplied by MA and C Office and Industrial Supplies Limited.
According to an interim management letter on the audit of accounts for the Ministry of Health for the financial year ended December 31 2020 and seen by News Diggers, the ventilators in question could not accurately measure the levels of oxygen being administered to patients on ventilation.
Auditor General Dick Sichembe, who signed off the letter, revealed that MA and C Office and Industrial Supplies Limited had not availed the service manual to UTH, making it difficult to undertake routine maintenance and repairs.
“An inspection of the ventilators supplied at the University Teaching Hospital carried out in April 2021 revealed the following; the 25 VG ICU ventilators delivered to UTH had an error (fault) message of “oxygen sensor failure,” an indication of a faulty or expired oxygen sensor. An oxygen sensor is an essential component of the Intensive Care Unit Ventilator. It measures the level of oxygen saturation being administered to a patient on ventilator support. Inquiries made with the end-user staff in Pediatric and Obstetric Intensive Care units at the UTH Children Hospital and Women and Newborn Hospital respectively revealed that although the ventilators were currently in use, they could not measure accurately the levels of oxygen being administered to patients on ventilation,” read the letter.
“Seven ventilators had an error (fault) message of “battery calibration required,” an indication of a malfunctioning of the internal battery system. According to the technical specifications, a service manual was to be provided with the ventilators by the supplier. However, inquiries made with the Biomedical Engineers at UTH revealed that the supplier had not provided the service manual, making it difficult for them to undertake routine maintenance and repairs.”
The Auditor General also revealed that two ventilators which had been installed in the main ICU had been withdrawn because of technical failure.
“Two VG 70 ventilators which had initially been installed in the main ICU had since been withdrawn due to unidentified technical failure and were currently stored in the Biomed Workshop and could not be worked on by the Bio-medical engineers due to non-availability of service manuals. Risks, wasteful expenditure as the equipment is not able to serve the intended purpose. Patient’s lives are endangered as a result of sub-standard medical equipment,” the Auditor General stated.
The Auditor General further stated that the ventilators, which were supposed to have standard settings for both adults and neonatal applications, had no settings for administering ventilation on neonatal babies, putting their lives at risk.
“Recommendation, management should engage the supplier to ensure that the sensors, battery system, technical failure are attended to and service manual is availed as provided for in the contract. Limited functionalities; according to the specifications, the ventilators were supposed to have standard settings for both adults and neonatal applications. However, inquiries made with end user staff from the Neonatal Intensive Care Unit revealed that the VG 70 ICU ventilators had no settings for administering ventilation on neonatal babies. Risks, wasteful expenditure. Patient’s lives are endangered as a result of sub-standard medical equipment,” the letter read.
The Auditor General stated that as of May 2021, the hospital biomedical engineers and staff had not been trained by the supplier in the operation and handling of comprehensive ICU ventilators.
“According to the schedule of requirements of the contract, the supplier was expected to conduct training of the hospital biomedical engineers and staff in the operation and handling of comprehensive ICU ventilators. However, inquiries at UTH where the ventilators were delivered revealed that as of 17th May 2021, the hospital biomedical engineers and staff had not been trained by the supplier seven months after delivery. Risk, the operation of the ventilators might not be effective due to the lack of specific knowledge required to operate and manage the particular model. Recommendation, the ministry must engage the supplier to ensure that training is conducted,” the letter read.
The Auditor General, however, stated that as of May 17, 2021 no payment had been made to the supplier.
“Award of contract for supply and delivery of specialized medical equipment- contract no. MOH/SP/COVID-19/002/20-25). On 21st April, 2020, the Ministry of Health entered into a contract with MA and C Office and Industrial Supplies Limited for the supply and delivery of fifty comprehensive ICU ventilators BIVENT and PRV (VG70), device trolleys and associated accessories and spares at a contract sum of US$1,125,000 VAT exclusive with a delivery period of 12 to 18 weeks. As of 17th May 2021, no payment had been made to the supplier for the delivered ventilators. A physical verification carried out at Medical Stores Limited warehouse in April 2021 revealed that the supplier delivered 50 VG70 ventilators in October 2020 some of which were distributed,” read the letter.
“According to clause 16 of the special conditions of the contract, the Ministry was required to pay the supplier within 60 days of submission of documents specified in the General Conditions of Contract (GCC) Clause 11 (delivery and documents) by cheque or direct bank transfers to the supplier’s nominated bank account upon submission of documents specified in GCC Clause 11. However, a review of the cash books and delivery documents revealed that the supplier completed the deliveries and submitted the documents specified in GCC clause 11 by 13th October, 2020 and as of 17th May 2021, the supplier had not been paid any amount of the contract price of US$ 1,125,000. Risks, the supplier may fail to perform the contract in full. The responsive efforts against the pandemic are negatively impacted. Management should ensure that payment schedules agreed in the contract are followed to ensure that programs are not hampered.”